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Emily: Pharm 2 > Antimicrobials > Flashcards

Antimicrobials Flashcards

1
Q

What is Minimum Inhibitory Concentration (MIC):

A

Lowest concentration of antibiotic required to prevent growth.

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2
Q

What is minimum Bactericidal Concentration (MBC)

A

Lowest concentration required to kill bacteria

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3
Q

List bactericidal medications:

A
  • Penicillins
  • Cephalosporins
  • Aminoglycosides
  • Vancomycin
  • Quinolones
  • Aztreonam
  • Imipenem
  • Bacitracin
  • Polymyxins
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4
Q

List Bacteriostatic medication:

A
  • Tetracyclines
  • Erythromycin
  • Sulfonamides
  • Trimethoprin
  • Clindamycin
  • Chloramphenicol
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5
Q

List some narrow spectrum antimicrobials:

A
  • Penicillin G
  • Erythromycin
  • Clindamycin
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6
Q

List some broad spectrum antimicrobials:

A
  • Ampicillin
  • Aminoglycosides
  • Cephalosporins
  • Chloramphenicol
  • Tetracyclines
  • Quinolones
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7
Q

List some medications that have a concentration dependent killing

A
  • Aminoglycoside

- Fluoroquinolones

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8
Q

List some medications that have a time dependent killing:

A
  • Beta Lactams
  • Monobactam (Aztreonam)
  • Macrolides (Erythromycin, Clindamycin)
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9
Q

T/F: Continous infusion has shown to be more effective than intermittent boluses for time dependent killing of microbes.

A

FALSE (Continuous infusion has NOT shown…)

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10
Q

What is post antibiotic effect (PAE):

A

antibiotics continue to suppress the growth of bacteria even after the antibiotic is no longer detectable

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11
Q

List some common facts about post antibiotic effects:

A
  • Demonstrated for virtually all antimicrobials
  • Can be decreased in acidic (infected) media
  • During the PAE phase, bacteria are more susceptible to killing by leukocytes
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12
Q

List the mechanisms for acquired resistance to antibiotics:

A
  • decreased permeability
  • Increased efflux pumps
  • Inactivation
  • Modification of the antimicrobial target
  • Development of pathways that bypass the target
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13
Q

What is decreased permeability:

A

-Antibiotics enter the outer membrane of gram - bacteria through specialized channels or porins

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14
Q

Increased efflux is less common, but can be important for what antibiotics:

A
  • Macrolides
  • Fluoroquinolones
  • beta lactams
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15
Q

What inactivates beta lactams:

A

beta-lactamases

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16
Q

Target modification in penicillin binding proteins account for methicillin resistance in staphylococcus and penicillin resistance in :

A
  • pneumococci

- enterococci

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17
Q

List the responses of using combo drugs such as antagonism, indifferent, inbetween, additive, synergistic:

A
  • antagonism is 1 + 1 = 0.5
  • indifferent is 1 + 1 = 1
  • Inbetween is 1 + 1 = 1.5
  • Additive is 1 + 1 = 2
  • Synergistic is 1 + 1 = 3
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18
Q

What are the general principal of therapeutic antimicrobial use:

A
  • Delivery
  • Concentration
  • Time period
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19
Q

List the five clinical situations bactericidal therapy is essential for clinical use:

A
  • Cardiovascular
  • meningitis and cerebral abscess
  • Invasive bacterial infection in severely neutopenic patient
  • Osteomyelitis
  • Treatment of infected prosthesis without removing the device
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20
Q

Effective antibiotic therapy involves integrating information regarding the:

A
  • Patient
  • Invading microbe
  • Antimicrobial agents
21
Q

What antibiotics are safe for use with a pregnant patient:

A
  • penicillins
  • cephalosporins
  • erythromycin
22
Q

What antibiotics are okay for use if necessary:

A
  • Aminoglycosides

- Isoniazid

23
Q

Which medication should be avoided in pregnancy:

A
  • Metranidazole
  • ticarcillin
  • rifampin
  • trimethoprim
  • fluoroquinolones
  • tetracyclines
24
Q

What will tetracycline do in pregnancy:

A

-cause acute fatty necrosis of the liver, pancrease, and possible renal injury

25
Q

What is the 80 percent of nosocomial infection with respiratory, blood, and urinary tract and name the organism.

A

-Respiratory is 24%
Staph and gram -

-Blood is 17%
S. epidermidis, S. aureus, and enterococcus

-Urinary is 36%
S. aureus, psuedomonas, E.coli, candida

26
Q

List from greatest to least the infection associated with central lines from femoral, I.J., and subclavian:

A
  • Femoral
  • I.J.
  • Subclavian
27
Q

How long is the treatment for catheters infected with S. Aureus:

A

2 - 4 weeks

28
Q

Need for surgical prophylaxis depends on:

A
  • Risk for infection
  • Patient related factors
  • Bacterial milieu
  • Hospital infection rate for varius procedures
  • Factors relating to the wound itself
29
Q

Median sternotomies usually have ___ and are covered by cefazolin.

A

Gram +

30
Q

What type of antibiotic would be used for infected tissues or prosthetic cardiac valves for cellulitis and osteomyelitis:

A

-antistaphylococcal antibiotics

31
Q

What antibiotics would be used for urinary tract infection with gram - bacilli:

A
  • Fluoroquinolones
  • aminoglycosides
  • 3rd generation cepholosporins
32
Q

What is an emerging fluconazole resistant fungal:

A

-C. albicans

33
Q

Clindamycin is similar to erythromycin, but is more active against many _____.

A

Anaerobes

34
Q

What is a leading cause of gastrointestinal infection:

A

-Clostridium Difficile

35
Q

What is the treatment for C. Difficile:

A
  • Metronidazole 1st line
  • Vancomycin 2nd line
  • Dificid (fidaxomicin)
36
Q

List the antimicrobials by class:

A
  • Beta Lactams
  • Cephalosporins
  • Monobactams, Carbapenems
  • Macrolides
  • Fluoroquinolones
  • Tetracyclines
  • Aminoglycosides
  • Miscellaneous Agents
37
Q

What antimicrobial affects the cell wall integrity:

A

B-Lactams

38
Q

What anitmicrobial affects the DNA synthesis:

A

Metronidazole

39
Q

What anitmicrobial affects the DNA gyrase:

A

-Quinolones

40
Q

What anitmicrobial affects the RNA polymerase:

A

-Rifampicin

41
Q

What anitmicrobial affects the Phospholipid membranes:

A

-polymyxins

42
Q

What anitmicrobial affects the Protein synthesis of 30s inhibitors:

A
  • Tetracylines
  • Streptomycin
  • Spectinomycin
  • Kanamycin
43
Q

What anitmicrobial affects the protein synthesis of 50s inhibitors:

A
  • Erythromycin
  • Choramphenicol
  • Clindamycin
  • Lincomycin
44
Q

What anitmicrobial affects the Cell wall synthesis:

A
  • D-cycoserine
  • Vancomycin
  • Bacitracin
  • Penicilins
  • Cephalosporins
  • Cephamycins
45
Q

What do beta lactams work:

A

-bind to the penicillin binding protein due to similar structure to D-alanyl-D-alanine

46
Q

What are some beta lactamse inhibitors:

A
  • Sulbactam
  • Tazobactam
  • Clavulanic Acid
47
Q

Facts about penicillins:

A

ADMINISTRATION:

  • PVK is PO
  • PCN G is IV/IM

HALF LIFE
0.5 hours

EFFECTIVE AGAINST:
-Strep a and b, some pneumococci, enterococci, H. influenzae, N. meningitis, Treponema pallidum

ADVERSE EFFECTS:
Hypersensitivity, GI upset, diarrhea, JARISCH-HERXHEIMER rxn

-ELIMINATION
renal

48
Q

T/F: Ampicillin has a wide tissue distribution including the CNS when inflammed.

A

TRUE

Emily: Pharm 2 (11 decks)

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